重庆市产后抑郁症发生情况及其影响因素分析

Prevalence and related factors of postpartum depression in Chongqing

摘要:

目的：探究重庆市产后抑郁症的发生情况及其影响因素。方法：采用一般情况调查表和爱丁堡产后抑郁量表（The Ed－inburgh postnatal depression scale，EPDS），根据纳入和排除标准，随机选取2014年9月至2016年6月在重庆医科大学3家附属医院做产检的371例产妇进行访谈完成产前量表；追踪至产后42 d完成分娩情况调查表、EPDS，EPDS≥13分需2位精神专科医生进行访谈综合评估，根据美国精神障碍诊断与统计手册（第4版）（DSM-IV-TR）轴I型障碍临床结构式访谈患者版（SCID-I/P）产褥期抑郁障碍诊断产后抑郁症。数据采用SPSS22.0进行统计分析。结果：60例产妇符合SCID-I/P产褥期抑郁症的诊断标准，产后抑郁症（postpartum depression，PPD）的发生率为16.17%，多因素分析显示：产前艾森克人格问卷（Eysenck Personality Questionnaire，EPQ）总分（OR=1.038，95%CI=1.013～1.065）、产前汉密尔顿焦虑得分（OR=1.119，95%CI=1.052～1.190）、分娩时单方家属陪伴（OR=17.998，95%CI=6.715～48.241）、分娩时出现异常情况（OR=66.279，95%CI=23.307～188.476）是产后抑郁症的危险因素。社会支持利用度是产后抑郁症的保护因素。结论：产前EPQ总分、产前汉密尔顿焦虑得分、分娩时单方家属陪伴、分娩出现异常情况是产后抑郁症的危险因素。社会利用支持度是产后抑郁症的保护因素。

Abstract:

Objective：To investigate the occurrence of the postpartum depression（PPD） and its influencing factors in Chongqing. Methods：Totally 371 pregnant women（pregnency≥28 weeks） from 3 hospitals completed the designed questionnaire and the respon－dents were followed 42 days after delivery and completed The Edinburgh postnatal depression scale（EPDS）. The data were collected from September 2014 to June 2016. Then the evaluation and diagnosis were conducted. Results：Sixty women was diagnosed with the PPD，the incidence of the PPD was 16.17%. Multivariate stepwise logistic regression analysis showed that Eysenck Personality Question－naire score（OR=1.038，95%CI=1.013 to 1.065），HAMA score（OR=1.119，95%CI=1.052 to 1.190），unilateral family company（OR=17.998，95%CI=6.715 to 48.241），abnormal in childbirth（OR=66.279，95%CI=23.307 to 188.476），the degree of social utilization are influence factors of PPD. Conclusion：Unilateral family company，abnormal in childbirth，EPQ score，HAMA score are independent risk factors for PPD，and the high degree of social utilization is the protect factor for PPD.